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NAILING IT — THE SURPRISING SIGNS OF MELANOMA

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NAILING IT — THE SURPRISING SIGNS OF MELANOMA

Janine Mendes-Franco

Melanoma is a serious form of skin cancer that originates in the melanocytes — the cells responsible for producing melanin, the pigment that gives skin its colour. While more rare than other types of skin cancer, it’s also more dangerous due to its tendency to spread to other parts of the body if not detected early.

  • Superficial spreading melanoma is the most common type (found in about 70% of cases). It typically appears on the trunk of the body in men and on the legs in women.

  • Nodular melanoma grows quickly and is more likely to spread. It often presents as a blue-black or reddish bump.

  • Lentigo maligna melanoma typically occurs in sun-damaged areas, such as the face and neck, and is often found in older patients

  • Acral lentiginous melanoma appears on the palms, soles of the feet, or under the nails, and is more common in people with darker skin tones. 

Melanoma under the nails

Known as subungual melanoma, this condition is rare but potentially deadly if not caught early. It often appears as a dark stripe or discolouration under the nail and can easily be mistaken for a bruise or fungal infection. The legendary reggae musician Bob Marley died from this form melanoma, which began under his toenail. His case highlights the importance of recognising and treating this form of melanoma early. You also need to beware of the dangers of UV nail dryers. 

Causes and risk factors

Several factors increase the risk of developing melanoma:

  • UV exposure from the sun or tanning beds can damage the DNA in skin cells, leading to mutations.

  • Less melanin puts you at higher risk, since this pigment provides some level of protection against UV radiation.

  • Family history of melanoma naturally increases the risk.

  • Moles (especially if they are abundant or atypical) increase the potential of developing the condition.

  • Weakened immune systems, as can happen with immunocompromised people, can make them more susceptible.

What to look out for 

Early detection is crucial, so be vigilant about: 

  • New moles or growths on the skin, or changes (size, shape, colour) to existing ones. This is a helpful guide. 

  • Nail changes such as dark streaks or discolouration under the nails, especially if they do not heal or grow out with the nail.

If you notice any suspicious changes in your skin or nails, come in and see us as soon as possible. 

Treatment

Depending on the type and stage, melanomas can be approached with a combination of: 

  • Surgery to remove the tumour.

  • Immunotherapy, which helps boost the body’s immune system.

  • Targeted treatments via drugs that hone in on specific genes and proteins contributing to cancer growth.

  • Chemotherapy, though this is a less common approach for melanoma.

  • Radiation, which uses high-energy rays to kill cancer cells, especially if the melanoma has spread.

Prevention and early detection

This is often contingent on reducing UV exposure and regularly monitoring your skin for changes.

  • Use sunscreen — A broad-spectrum sunscreen with an SPF of 30+ is best, even on cloudy days. Try to avoid direct sun exposure between 10 a.m. and 4 p.m. when UV rays are strongest, and wear protective clothing when you are out in the sun. 

  • Avoid tanning beds — They emit harmful UV radiation and increase the risk of skin cancer.

  • Check yourself — Monitor your skin monthly, paying special attention to areas not exposed to the sun, including under the nails.

Stay sun-safe!